Age-related prevalence of cardiac valvular abnormalities warranting infectious endocarditis prophylaxis

Croft, Lori B.; Donnino, Robert; Shapiro, Robert; Indes, Jodi; Fayngersh, Alla; Squire, Anthony; Goldman, Martin E.

doi:10.1016/j.amjcard.2004.04.045

Cited by 22 publications

(8 citation statements)

References 11 publications

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“…Endothelial damage may result from mechanical lesions provoked by turbulent blood flow, electrodes or catheters, inflammation, as in rheumatic carditis, or degenerative changes in elderly individuals, which are associated with inflammation, microulcers, and microthrombi. Degenerative valve lesions are detected by echocardiography in up to 50% of asymptomatic patients over 60 years, 33 and in a similar proportion of elderly patients with IE. This might account for the increased risk of IE in the elderly.…”

Section: Pathophysiologymentioning

confidence: 98%

Indoor Navigation for a Humanoid Robot Using a View Sequence

Ido

Shimizu

Matsumoto

et al. 2009

The International Journal of Robotics Research

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Humanoid robots are expected to work in the human environment due to their similarity to the human shape, and they are required to achieve localization and navigation autonomously. In this paper, indoor navigation is realized based on a view-based approach using a camera mounted on the head. In the case of a humanoid robot, image blur and swing due to walking is a crucial issue for image matching during localization. The quantitative effect of walking on the image is firstly investigated by utilizing a motion capture system. Then a method to generate a stable view sequence is proposed based on the detection of optical flows. The navigation function with the proposed method was implemented on a humanoid robot HRP-2, and the effectiveness was confirmed by indoor walking experiments.

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Section: Pathophysiologymentioning

confidence: 98%

Indoor Navigation for a Humanoid Robot Using a View Sequence

Ido

Shimizu

Matsumoto

et al. 2009

The International Journal of Robotics Research

View full text Add to dashboard Cite

show abstract

“…Valve scarring and calcification related to rheumatic carditis or valve sclerosis in elderly patients result in endothelial lesions. Degenerative valve lesions are detected in up to 50% of patients older than 60 years of age and may explain the increased risk for IE in the elderly [4]. Extrinsic intervention, such as prosthetic valve replacement or indwelling electrodes or catheters, also promotes endothelial lesions.…”

Section: The Critical Role Of Host Factorsmentioning

confidence: 99%

New concepts in the pathophysiology of infective endocarditis

Widmer¹,

Que²,

Entenza³

et al. 2006

Curr Infect Dis Rep

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Endocarditis pathogens colonize valves with pre-existing sterile vegetations or valves with minimal endothelial lesions. Inflamed endothelia produce cytokines, integrins, and tissue factor, which in turn attract fibronectin, monocytes, and platelets. Bacteria attaching to such structures further activate the cascade, becoming embedded and protected from host defenses. Staphylococcus aureus also actively invade the endothelium, causing apoptosis and endothelial damage. Knowledge of this interplay identifies host factors as potential therapeutic targets. Blocking infection by modulating host factors might be opportune because host factors are conserved. In contrast, interfering with bacterial virulence factors might be more complicated because they vary among different bacteria.

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“…9 Some authors therefore suggest that the current focus on antibiotic prophylaxis is an unproved, expensive, and potentially harmful standard of care, whereas others argue that it prevents cases of infective endocarditis 210 11 12 13 Owing to ethical and medicolegal issues, cost, and the large number of patients necessary to achieve statistically significant results, a randomised placebo controlled trial of antibiotic prophylaxis has never been attempted 14…”

Section: Introductionmentioning

confidence: 99%

Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study

Thornhill

Dayer

et al. 2011

BMJ

222

131

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Objective To quantify the change in prescribing of antibiotic prophylaxis before invasive dental procedures for patients at risk of infective endocarditis, and any concurrent change in the incidence of infective endocarditis, following introduction of a clinical guideline from the National Institute for Health and Clinical Excellence (NICE) in March 2008 recommending the cessation of antibiotic prophylaxis in the United Kingdom.Design Before and after study.Setting England.Population All patients admitted to hospital in England with a primary or secondary discharge diagnosis of acute or subacute infective endocarditis.Main outcome measures Monthly number of prescriptions for antibiotic prophylaxis consisting of a single 3 g oral dose of amoxicillin or a single 600 mg oral dose of clindamycin, and monthly number of cases of infective endocarditis, infective endocarditis related deaths in hospital, or cases of infective endocarditis with a possible oral origin for streptococci.Results After the introduction of the NICE guideline there was a highly significant 78.6% reduction (P<0.001) in prescribing of antibiotic prophylaxis, from a mean 10 277 (SD 1068) prescriptions per month to 2292 (SD 176). Evidence that the general upward trend in cases of infective endocarditis before the guideline was significantly altered after the guideline was lacking (P=0.61). Using a non-inferiority test, an increase in the number of cases of 9.3% or more could be excluded after the introduction of the guideline. Similarly an increase in infective endocarditis related deaths in hospital of 12.3% or more could also be excluded.Conclusion Despite a 78.6% reduction in prescribing of antibiotic prophylaxis after the introduction of the NICE guideline, this study excluded any large increase in the incidence of cases of or deaths from infective endocarditis in the two years after the guideline. Although this lends support to the guideline, ongoing data monitoring is needed to confirm this, and further clinical trials should determine if antibiotic prophylaxis still has a role in protecting some patients at particularly high risk.

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Age-related prevalence of cardiac valvular abnormalities warranting infectious endocarditis prophylaxis

Cited by 22 publications

References 11 publications

Indoor Navigation for a Humanoid Robot Using a View Sequence

Indoor Navigation for a Humanoid Robot Using a View Sequence

New concepts in the pathophysiology of infective endocarditis

Impact of the NICE guideline recommending cessation of antibiotic prophylaxis for prevention of infective endocarditis: before and after study

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